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Br J Psychiatry. 2008 Mar;192(3):178-84. doi: 10.1192/bjp.bp.107.037192.

Self-harm in first-episode psychosis.

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1
Department of Psychological Medicine, Institute of Psychiatry, King's College London, Weston Education Centre, 10 Cutcombe Road, London SE5 9RJ, UK. s.harvey@iop.kcl.ac.uk

Abstract

BACKGROUND:

Little is known about self-harm occurring during the period of untreated first-episode psychosis.

AIMS:

To establish the prevalence, nature, motivation and risk factors for self-harm occurring during the untreated phase of first-episode psychosis.

METHOD:

As part of the AESOP (Aetiology and Ethnicity in Schizophrenia and Other Psychoses) study, episodes of self-harm were identified among all incident cases of psychosis presenting to services in south-east London and Nottingham over a 2-year period.

RESULTS:

Of the 496 participants, 56 (11.3%) had engaged in self-harm between the onset of psychotic symptoms and first presentation to services. The independent correlates of self-harm were: male gender, belonging to social class I/II, depression and a prolonged period of untreated psychosis. Increased insight was also associated with risk of self-harm.

CONCLUSIONS:

Self-harm is common during the pre-treatment phase of first-episode psychosis. A unique set of fixed and malleable risk factors appear to operate in those with first-episode psychosis. Reducing treatment delay and modifying disease attitudes may be key targets for suicide prevention.

Comment in

PMID:
18310576
DOI:
10.1192/bjp.bp.107.037192
[Indexed for MEDLINE]
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